Anterior decompression with fusion versus posterior decompression with fusion for massive cervical ossification of the posterior longitudinal ligament with a ≥50% canal occupying ratio: a multicenter retrospective study

The present study demonstrated that the postoperative recovery rate was similar in the ADF and PDF group. In patients with massive OPLL with kyphotic alignment, neurologic recovery rate in the ADF was superior to that in the PDF (in situ fusion). Additionally, postoperative neck pain was less severe in the ADF group. However, the occurrence of perioperative complications was more common in the ADF group.